The Relationship Between Peripartum Cardiomyopathy and Preeclampsia – Pathogenesis, Diagnosis and Management

Abstract

Peripartum cardiomyopathy (PPCM) is a condition with an incompletely understood etiology, although many risk factors for this disorder have been mentioned. Preeclampsia (PE) is a rare but undoubtedly very important cause of PPCM. Early recognition and prompt treatment of preeclampsia and peripartum cardiomyopathy are essential to optimize pregnancy outcomes. An extensive manual search of major electronic databases was conducted in November 2021. The following literature review provides a comprehensive discussion of peripartum cardiomyopathy and preeclampsia and quantifies the prevalence of PE in women with PPCM. The authors highlighted aspects such as epidemiology, risk factors, cardiovascular changes, diagnosis and clinical presentation, and management and complications. Accumulating data indicate that both conditions have a similar pathogenesis characterized by vascular abnormalities. In both conditions we can observe an increase in interleukin-6 and gamma interferon, CCL2/MCP1, and decreased SOD activity. sFLT1 (a soluble form of fms-like tyrosine kinase 1), a substance with antiangiogenic and probably cardiotoxic effects, may be important. Preeclampsia and peripartum cardiomyopathy are characterized by recurrence rates that follow a similar pattern in subsequent pregnancies, and mortality remains a concern. Our analysis highlights the need to better understand the co-morbidity of PE and PPCM, and the need to qualify patients for the same clinical trials because of the common origin of these conditions.

Abordaje inicial de enfermería en pacientes preeclampticas con signos de severidad en emergencia

“…El enfermero deberá estar atento a las quejas que presenta la paciente con preeclampsia como es el dolor de cabeza, disnea dolor epigástrico, náuseas, Liliana Patricia Vega-Lombeida; Neris Marina Ortega-Guevara; Maria Aidé Dávila-Quishpe 514 vómitos o alteraciones visuales. Además, debe tomar las muestras para los análisis de sangre 15 .…”

A patient with untreated preeclampsia and peripartum cardiomyopathy

“…The pathophysiology of peripartum cardiomyopathy is not entirely understood but has links to preeclampsia 1,3,16. One theory is that a soluble form of fms-like tyrosine kinase-1 (sFLt-1), a factor that is secreted from the placenta, can cause systolic heart failure and has been shown to potentially have cardiotoxic effects 1,17,18. Increased SFLt-1 levels are found in patients with preeclampsia and those with peripartum cardiomyopathy, leading to suspicion that the development of these two conditions are linked 1,16,17…”

“…1,3,16 One theory is that a soluble form of fms-like tyrosine kinase-1 (sFLt-1), a factor that is secreted from the placenta, can cause systolic heart failure and has been shown to potentially have cardiotoxic effects. 1,17,18 Increased SFLt-1 levels are found in patients with preeclampsia and those with peripartum cardiomyopathy,…”

Review Literatur: Pentingnya Diagnosis Awal Kardiomiopati Peripartum

“…Hipertensi dalam kehamilan dan preeklamsia seringkali terjadi selama kehamilan pada pasien KMPP, dimana sekitar 22% pasien KMPP mengalami preeklampsia dan 47% mengalami hipertensi dalam kehamilan (Arany and Elkayam, 2016). Preeklampsia dan KMPP memiliki patofisiologi serupa yang diakibatkan oleh sekresi faktor anti-angiogenik dari janin (Kuć et al, 2022). Walaupun demikian, sebagian besar kasus preeklampsia tidak berkembang menjadi KMPP (Arany and Elkayam, 2016).…”